| NPI | 1518341593 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01086480A) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01086480A) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-19 | 
| Last Update Date | 2023-12-25 |